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. 2025 Mar 18;25(1):374.
doi: 10.1186/s12879-024-10316-0.

Survival and risk factor analysis in patients with septic arthritis: a retrospective study of 192 cases

Melanie Schindler  1   2 , Lorenz Huber  3 , Nike Walter  3   4 , Josina Straub  3 , Siegmund Lang  3 , Dominik Szymski  3 , Susanne Baertl  3 , Dietmar Dammerer  1 , Volker Alt  3 , Markus Rupp  5   6
Affiliations

Survival and risk factor analysis in patients with septic arthritis: a retrospective study of 192 cases

Melanie Schindler et al. BMC Infect Dis. .

Abstract

Background: Septic arthritis (SA) presents a complex clinical challenge, often resulting in significant morbidity and mortality. This study aimed to (1) assess overall mortality rates and (2) identify potential factors contributing to increased mortality risk in patients with SA.

Methods: This retrospective study on SA patients treated at a German university hospital between January 1, 2011, and December 31, 2021. Patients were identified using International Classification of Diseases (ICD)-10 codes for septic arthritis, specifically "M00.-". The study evaluated mortality rates and analyzed comorbidities, pathogens, and other potential risk factors. Kaplan-Meier survival curves and odds ratios (OR) were calculated to assess mortality risk.

Results: In a cohort of 192 patients diagnosed with SA, 64 patients (33.3%) died during a mean follow-up period of 54.4 ± 42 months. The overall mortality rate was 17.5% at one year, 19.9% at two years, and 28.3% at five years. Patients aged 65 years or older, as well as those with arterial hypertension, congestive heart failure, chronic renal disease, chronic liver disease, malignancy, steroid use and immunosuppression showed significantly higher mortality rates (p < 0.05). Chronic renal disease (OR = 2.80), malignancy (OR = 3.40), and chronic heart failure (OR = 2.62) were identified as significant notably risk factors for mortality.

Conclusion: This study highlights a notably high mortality rate among vulnerable patients with SA, particularly those with pre-existing comorbidities. Recognizing and addressing these risk factors early could improve patient outcomes. These results unterscore the need for close monitoring of SA patients, particularly those with chronic organ conditions, and timely intervention for sepsis to reduce mortality risk.

Keywords: Comorbidities; Complication; Mortality; Septic arthritis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was approved by the Investigational Review Board of University Hospital Regensburg. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan-Meier probability plots of mortality related to age ≥ 65, arterial hypertension, chronic heart failure, chronic renal disease, steroid and immunosuppression use
Fig. 2
Fig. 2
Mortality odds ratio for epidemiological and environmental factors
Fig. 3
Fig. 3
Mortality odds ratio for affected joints
Fig. 4
Fig. 4
Mortality odds ratio for comorbidities
See this image and copyright information in PMC

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